1 / 42

GI Radiology

GI Radiology. Imaging modalities in GI. Plain X-rays (Supine, Erect, Decubitus) Barium studies (Ba Swallow, Meal, Follow through, Enteroclysis, Enema) Ultrasound Abdomen CT Scan/MRI Abdomen ERCP, Cholangiography. Angiography and Nuclear Medicine. Plain Abdominal X-rays. Erect Chest

moeshe
Télécharger la présentation

GI Radiology

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. GI Radiology

  2. Imaging modalities in GI • Plain X-rays (Supine, Erect, Decubitus) • Barium studies (Ba Swallow, Meal, Follow through, Enteroclysis, Enema) • Ultrasound Abdomen • CT Scan/MRI Abdomen • ERCP, Cholangiography. • Angiography and Nuclear Medicine

  3. Plain Abdominal X-rays • Erect Chest • Supine Abdomen • Erect / Decubitus Abdomen ( 10 min ) • Radiation Dose ( 1 Abd = 75 CXR) • Contraindicated – pregnancy

  4. Indications. • “Acute Abdomen” • Abdominal Pain. • ?Obstruction. • Not Indicated for: • Trauma. • Solid organ assessment.

  5. Basic Principles • Five radiographic densities: • Gas/Air • Fat. • Soft Tissue/Water • Bone/Calcium • Metals • Interface/line only visible when two of these densities interface with each other.

  6. Approach to a AXR • Technical Assessment. • Projection. • Bowel/Gas Shadows. • Normal/Abnormal Calcifications. • Solid Organs. • Look at lung bases and at the skeleton.

  7. Stomach. Colon. Small Bowel. Within the Lumen: Dilated bowel ?Obstruction Outside the Lumen: Free ?perforation In a cavity ?abscess Normal Vs Abnormal Gas shadows

  8. Water Soluble Ionic (gastrografin) Can lead to pulmonary edema if aspirated. Non- Ionic ( Low Osmolar) Relatively safer if aspirated. Gadolinium (MRI) Barium ( Non-water soluble) Can cause sever peritonitis and fibrosis in perforation or leakage. Contrast Medium for GI

  9. Indications: Dysphagia Pain Reflux Anemia Tracheo-esophageal fistula Perforation Contraindications: Aspiration Contrast Swallow

  10. Indications: Dyspepsia Upper abdominal mass Weight Loss Gastrointestinal Hemorrhage. Partial Obstruction Assessment for perforation Contraindications Complete large bowel obstruction Pateint preparation: NPO ---6 hrs No smoking– increases GI motility Barium Meal

  11. Indications: Pain Diarrhoea Anemia/GI bleed Partial Obstruction Malabsorption Abdominal mass Contraindications Complete obstruction Patient Preparation: Low residue diet Bowel Prep (Dulcolax -2-4 Tab) Small Bowel Follow through/ Small bowel enema (Enteroclysis)

  12. Small Bowel follow through VS Small bowel enema

  13. Indications: Change in bowel habits Pain Mass Melaena / Anemia Single contrast – Obstruction & Intussusception. Contraindications: Rectal biopsy—5 days Toxic megacolon Pseudomembranous colitis Preparation: (Two days) Low residue diet Bowel prep (Dulcolax – 4 Tab) Barium Enema

  14. Advantage Cost effective Adequate visceral visualization Best for GB No radiation Indications:Acute Abdomen, Obstructive jaundice, abdominal masses, collections, Free fluid, follow up- tumors. Disadvantage Operator dependent Poor in Obesity Bowel gasses Bones / Calcifications UltrasoundAbdomen

  15. Advantages Accurate & quick Bowel/ gasses/ bones Reformation and angio Indications: Acute abdomen, Abdominal mass, tumor staging/follow up, Appendicitis/abscesses, Post op complications Disadvantages: Radiation (250 CXR) Renal failure Contrast reaction CT Scan Abdomen

  16. Advantages Multiplaner Renal failure MRCP Liver specific contrasts Disadvantages Bowel motion/ contrast Calcifications Metallic implant Relatively long procedure time Claustrophobia MRIAbdomen

  17. EndoscopicRetrograde Cholangiopancreatography (ERCP) MR Cholangiopancreatography (MRCP) T-tubeCholangiography. Percutaneous Transhepatic Cholangiography (PTC). Cholangiography

More Related